Insight by Dominion National

COVID-19 put the focus on health, but don’t ignore dental this Open Season

This content is provided by Dominion National.

The COVID-19 pandemic has had Americans putting several activities on hold; however, now there is a huge influx of people going back to the dentist to regain control of their oral health. The question is, will this spike in the popularity of dental care translate into careful examination of dental plans during fall’s Open Season?

It should, especially this year. That’s because the Federal Employees Dental and Vision Program is entering a new seven-year contract term in 2021, which means the number of carriers is increasing. That makes this year’s Open Season one of the best times to reexamine the plans available to federal employees and TRICARE retirees, because plans and premiums may be changing.

But feds in the Mid-Atlantic region will likely see an old favorite returning on that list. This is the second seven-year contract term that FEDVIP is offering the Dominion National Dental HMO (DHMO) plan, the only DHMO plan available to FEDVIP participants.

What is a Dental HMO?

“Dental HMO plans include predictable, pre-determined fees,” said Mike Davis, Dominion National president. “They are designed for transparency for members and dentists in that there are specific copayments listed for each covered service. If you know what dental procedures you need to have completed, you will know how much you will pay for your dental care before you even go to the dentist. A DHMO also provides immediate access to care, meaning no waiting periods, no annual maximum limits and overall just the peace of mind that you don’t have to worry about unexpected costs.”

Contrast that with a PPO, which covers a percentage, or coinsurance, of the total cost. But the total cost could vary depending on where the procedure is performed. For example, the average cost of a crown in the Washington, D.C. area is about $1,500. An enrollee using a PPO would have to contact his or her dental office to discover that price; the PPO only reveals the percentage it pays. A DHMO, on the other hand, ensures participants get the same fixed price as participating Dominion dentists agree to the same contracted fee, and that cost is revealed upfront.

A DHMO does require participants to stay in network, which is how it can offer those prices while keeping premiums lower. A PPO offers more flexibility to go outside the network. That element of choice is attractive to some participants – particularly if they have a relationship with their dentist and want to ensure they can continue receiving care from their dentist. It is important to consider if you will need to go outside the network in your dental plan evaluation. PPOs might make sense for someone who travels a lot, which could make it hard to stay in network. However, if your dentist participates in a DHMO network and you plan to receive dental treatment locally, a DHMO might make sense if you are looking to pay a lower premium.

Why reevaluate your options?

People’s health care needs change as their lives change. Some people may only require preventive care like cleanings and exams offered by the standard option plans. However, others may need high-option plans that cover procedures like crowns, implants and restorative services.

In addition, dental health has been linked to overall health in a number of studies, which have linked gum disease to oral cancer, heart disease, diabetes, respiratory ailments, preterm birth, skin diseases, thyroid problems and leukemia.

“We recently conducted a study with Capital BlueCross and Geneia, LLC that associates receiving recommended preventive dental care with reduced emergency room visits and hospitalizations for people with chronic medical conditions,” Davis said. “Minimizing emergency room visits and in-patient hospital stays can be associated with significant savings on medical expenses. Dental can help play a role.”

That’s why Dominion National created an incentive plan to help encourage participants to get regular dental checkups.

“Each family member enrolled with Dominion who receives two cleanings during the plan year will be reimbursed for their $10 office visit copayments made to the dentist at the time of service – a total reimbursement of $20 per family member. We submit a check for the reimbursement to the primary subscriber,” Davis said. “This has been very well-received and can move the dial on member satisfaction and retention.”

In response to the COVID-19 pandemic, Dominion National reduced the minimum requirement for reimbursement to a single cleaning in 2020.

“Fortunately, we are seeing dental utilization normalizing in recent months as dental offices have been reopening for routine care,” Davis said. “We provide online resources for members to help prepare for their next dental office visit in this new climate, including recommendations published by the CDC and ADA.”

When and where to enroll

This year’s Federal Employees Dental and Vision Insurance Program (FEDVIP) open enrollment season for choosing a dental plan runs from Nov. 9, 2020, through midnight EST Dec. 14, 2020, for coverage effective Jan. 1, 2021. FEDVIP is available to Federal employees, retirees, TRICARE retirees and their families.

For more information on Dominion National’s DHMO, visit FederalDentalPlans.com. There you can review plan information, find a dentist, view an enrollment video and see a list of FAQ’s. To enroll, go to BENEFEDS.com.

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